【摘要】 目的了解中国内地 HIV/AIDS 合并结核感染的概况,总结分析 HIV/AIDS 合并结核感染者的临床表现、实验室检查以及治疗转归情况。方法采用统一调查表格收集中国内地不同省份的9家医院 HIV/AIDS 合并结核感染者的各项指标并进行统计分析。结果 HIV/AIDS 合并结核感染者241例,以男性（75.9%）青壮年为主。新疆和云南以静脉注射毒品感染为主,其他省市以输血及血制品（上海、河南、山西闻喜县）和性传播（福州、上海、深圳、云南德宏傣族景颇族自治州）为多。单纯肺结核占59.3%,肺外结核21.2%,肺内合并肺外结核19.5%。痰结核培养阳性率2.9%,痰抗酸染色阳性率9.5%,胸水或脑脊液标本抗酸染色阳性率10.8%,PPD 大多显示阴性或弱阳性。CD₄⁺T 淋巴细胞计数<200个/ul 的有76.8%,<100个/ul 的有58.5%。80.5%的患者接受抗结核治疗,69.7%的患者接受高效联合抗反转录病毒治疗（HAART）。存活203例（84.2%）,死亡38例（15.8%）。结论 9家医院的241例 HIV/AIDS 合并结核感染者以肺结核为多,临床表现多样,CD₄⁺T 淋巴细胞计数低下,免疫功能差。结核相关的实验室检查指标阳性率低,对诊断帮助不大。虽然大多数患者接受 HAART 和（或）抗结核治疗,但病死率达15.8%。更多还原

【Abstract】 Objective In order to take an insight into the profile of HIT/AIDS and tuberculosis （TB）co-infection,we made a statistic survey in 9 hospitals in China’s mainland.With the purpose of guiding the prevention and treatment,241 cases with such co-infection were enrolled and the data with respect to clinical manifestations,laboratory tests,therapy and prognosis were analysed.Methods All indices were collected with unified questionary.Results Young men（75.9%）took constituted the majority.HIV was transmitted mainly by intravenous drug use（IDU）in Xinjiang and Yunnan provinces,by blood transfusion or blood products in Shanghai,Henan and Wenxi county of Shanxi,and by sexual transmission in Fuzhou, Shanghai,Shenzhen and Dehong prefecture of Yunnan province.In this survey,pulmonary TB accounted for 59.3%,extra-pulmonary TB for 21.2%,and both for 19.5% of the patients.As for laboratory tests,only 9.5% was positive in sputum for acid-fast bacillus（AFB）and 2.9% in culture,10.8% of the patients had AFB in pleural fluid or cerebrospinal fluid.Besides,PPD was negative or weakly positive in most of the cases.Overall,76.8% of the 241 cases had a CD4 cell count<200/μl,and 58.5%<100/μl.80.5% of the patients was treated with anti-tuberculous medications and 69.7% with highly active antiretroviral therapy （HAART）.203（84.2%）were still alive and 38（15.8%）died.Conclusions（1）The clinical manifestations of the 241 cases were varied because of prevailing pulmonary TB.（2）The immune function was depressed with reducing CD₄ counts in most of the patients.（3）Positivity rate of examination relevant to TB was too low to help the diagnosis.（4）The mortality（15.8%）was high even with HAART and/or chemotherapy.更多还原